Health Behaviours

Created by: Rebecca_f
Created on: 29-04-20 14:43

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Health impairing habits: Behavioural Pathogens
- What are HBs?
  - Health protective behaviours: Behavioural Immunogens
  - Health behaviours
    - Why study?
      - Mortality: HBs account for more deaths than metabolic/environmental factors
      - Longevity: studies have shown that HBs are part of the reason for some parts of the world having longer life spans
    - 1) Health locus of control
      - How controllable we regard our health to be
      - 3 dimensions: internal (i am directly responsible), external (health is down to luck), and powerful others (can only do as the doctor says)
      - LoC related to behaviour change and adherence to medical advice
    - 2) Risk perception
      - Risk can be over or under estimated
        BUT studies show mostly unrealistically optimistic
        4 Cognitive Factors to UO: lack of personal experience, believe problem is preventable, believe problem hasn't appeared yet so wont in future, and belief that the problem is infrequent
        
        Perceptions of individual risk are not rational
    - Criticisms of HB theories
      - Problems with SCMs
        Overly complicated
        
        significant overlap between constructs that should be integrated: behavioural control, intentions and attitudes
        
        Models aren't successful at predicting behavioural intentions or actual behaviour
        
        Some behaviours are beyond the control of the individual, e.g. healthy diet in poverty
      - Problems with IMs
        The COM-B model encourages researchers and practitioners use of a one size fits all approach
        this can limit the development of newer theories that may be better
        
        Reduce professionals to mere technicians who follow prescriptive rues and guidelines
        
        Individualised health care? Goes against current recommendations that health care should be personalised
        
        Naive to believe that one model could explain all HBs carried out by all people
Why study?
- Mortality: HBs account for more deaths than metabolic/environmental factors
- Longevity: studies have shown that HBs are part of the reason for some parts of the world having longer life spans
1) Health locus of control
- How controllable we regard our health to be
- 3 dimensions: internal (i am directly responsible), external (health is down to luck), and powerful others (can only do as the doctor says)
- LoC related to behaviour change and adherence to medical advice
Sense of whether we are or are not susceptible to a health problem
- 2) Risk perception
  - Risk can be over or under estimated
    - BUT studies show mostly unrealistically optimistic
      - 4 Cognitive Factors to UO: lack of personal experience, believe problem is preventable, believe problem hasn't appeared yet so wont in future, and belief that the problem is infrequent
    - Perceptions of individual risk are not rational
3) Motivation and self-determination
- Need to be motivated to start new HB or change existing
- SDT looks at motives that regulate behaviour
  - 2 kinds of motivation
    - Autonomous motivation: behaviours that fulfil personally relevant goals
      - assoc with satisfaction, WB, persistence health related behaviours
    - Controlled motivation: driven by external factors/stimuli
      - assoc with lack of satisfaction and avoidance of HBs
- Health behaviours
  - Criticisms of HB theories
    - Problems with SCMs
      - Overly complicated
      - significant overlap between constructs that should be integrated: behavioural control, intentions and attitudes
      - Models aren't successful at predicting behavioural intentions or actual behaviour
      - Some behaviours are beyond the control of the individual, e.g. healthy diet in poverty
    - Problems with IMs
      - The COM-B model encourages researchers and practitioners use of a one size fits all approach
        this can limit the development of newer theories that may be better
      - Reduce professionals to mere technicians who follow prescriptive rues and guidelines
      - Individualised health care? Goes against current recommendations that health care should be personalised
      - Naive to believe that one model could explain all HBs carried out by all people
4) Self Efficacy
- Expansion of SLT: belief in capability to organise an execute sources required to manage prospective situations
- closely related to confidence in ability to engage in HB, e.g. confident to stop smoking
Theories of HB
- The 4 beliefs relate to HB and form key components of health theories
- Stage Models
  - Individuals move through ordered stages as they change behaviour
  - A stage model has 4 basic properties
    - A classification system which defines and labels each stage
    - Ordering of stages
    - People within the same stage face the same challenges
    - Each stage has unique challenges
Stage Models
- Individuals move through ordered stages as they change behaviour
- A stage model has 4 basic properties
  - A classification system which defines and labels each stage
  - Ordering of stages
  - People within the same stage face the same challenges
  - Each stage has unique challenges
Stages of Change Model
- 1. Pre-contemplation: not intention to change
  - 2. Contemplation: consider a change
    - 3. Preparation: making small changes
      - 4. Action: actively engaging in a new behaviour
        5. Maintenance: sustaining change over time
- Don't necessarily go through in sequence (can go back and forth, circular rather than linear)
E.g. i am happy being a smoker
- I have been coughing a lot, perhaps i should consider quitting
  - I won't drink and i will buy a smaller pack
    - I have stopped smoking
      - it has been 4 months since i smoked
1st half is the motivation stage: SE, outcome expectancy, threat appraisal
- The Health Action Process Approach
  - 2nd half Action stage: cognitive factors (action plans) and situational factors (support/barriers)
Social support: my friends will go to the gym with me
- Barriers: I don't have enough money for a membership
- Action plan: If if don'f feel like exercising i will look at this photo of me
Problems with stage models
- Does behaviour change occur in stages or continuum??
- Are there really distinct stages?
- If there are stags, changes between them may be so fast that a stage is not important
- Too simplistic?
- focuses on planning processes but do we really make table coherent plans?
- Things may change making your plan unachievable
Social Cognitive Models
- Examines the predictors and precursors to health behaviour; a continuum approach
- Based on SCT
  - behaviour is ruled by expectancies, incentives and social cognitions
    - Expectancies: a behaviour may be dangerous or reduce harm to health, or that a person is capable of the behaviour (SE)
    - Incentives: behaviour is governed by its consequences
    - Social Cognitions: reflect the individuals representation of their social worlds
- Protection Motivation Theory
  - Severity, susceptibility, responsive effectiveness, SE and fear channel into our behavioural intentions and thus behaviour
    - E.g. Severity: bowel cancer is serious
      - susceptibility: my risk is high
        RE: changing my diet would help
        SE: confident I can do that
        Fear: scared of getting BC
        Therefore, they intend to change
  - How people protect their health against risk
- Theories of HB
  - The 4 beliefs relate to HB and form key components of health theories
Protection Motivation Theory
- Severity, susceptibility, responsive effectiveness, SE and fear channel into our behavioural intentions and thus behaviour
  - E.g. Severity: bowel cancer is serious
    - susceptibility: my risk is high
      - RE: changing my diet would help
        SE: confident I can do that
        Fear: scared of getting BC
        Therefore, they intend to change
- How people protect their health against risk
Theory of Planned Behaviour
- Internal control factors and external control factors lead to behavioural control
- Beliefs about other peoples attitudes to behaviour and motivation to comply with them leads to subjective norms
- Beliefs about outcomes and evaluations of outcomes lead to attitudes towards behaviour
- Social Cognitive Models
  - Examines the predictors and precursors to health behaviour; a continuum approach
  - Based on SCT
    - behaviour is ruled by expectancies, incentives and social cognitions
      - Expectancies: a behaviour may be dangerous or reduce harm to health, or that a person is capable of the behaviour (SE)
      - Incentives: behaviour is governed by its consequences
      - Social Cognitions: reflect the individuals representation of their social worlds
- Attitudes towards the behaviour, subjective norms and behavioural control feed into behavioural intentions and actual behaviour
  - Attitudes: reducing alcohol intake would make my life more productive, and benefit my health
Perceived control: I am capable of drinking less alcohol because I believe I have the skills needed and the support available
- Attitudes: reducing alcohol intake would make my life more productive, and benefit my health
- Subjective norms: my family want me to cut down and that is important to me
Integrated models
- one model that consists of all of the most useful elements of previous theories
- Integrated models are small and focused
derived from analysis of 83 pre-existing theories (over 1000 variables)
- The COM-B model
  - Exposed 3 key factors: do not predict intentions but actual behaviour change
    - Motivation e.g. I want to use a condom and I believe that it is the right thing to do
    - Capability e.g. i have the skills needed to practice safe sex
    - Opportunity e.g. my partner wants me to use a condom and i have got some
  - Integrated models
    - one model that consists of all of the most useful elements of previous theories
    - Integrated models are small and focused
The intention behaviour gap
- core element of theories is the use of intention as a means to predict behaviour; this link is not always straightforward
- even the best intention may not translate to behaviour
- 2 ways to address this problem...
  - Past behaviour and habit
    - accounts for 13% of future behaviour
    - Can indirectly influence a change in cognition: more common in behaviours that are infrequent
    - Habit is automatic with little conscious processing: common in frequent behaviours with offer no new experience
Bridge the gap
- research highlights the role of variables such as emotion, commitment and planning that could mediate the intention-behaviour gap
- 2 ways to address this problem...
  - Past behaviour and habit
    - accounts for 13% of future behaviour
    - Can indirectly influence a change in cognition: more common in behaviours that are infrequent
    - Habit is automatic with little conscious processing: common in frequent behaviours with offer no new experience
- Implementation intentions: simple form of action plans have been well researched and effective. Require you to pan the what and the when of a particular behaviour

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Health Behaviours

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